Bruce J. Schulman: House Should Pass Senate Health Care Bill

As the congressional leadership ponders the way forward on national health care reform, a sense of anti-climax overwhelms Washington and the nation. The stunning special election in Massachusetts and the president’s State of the Union, with its vague language, have only intensified the confusion....

The architects of the most important social legislation in U.S. history, the Social Security Act of 1935, felt the same ambivalence abut their handiwork — and the same letdown about the final product. But Social Security became the bulwark of American social policy — the foundation of the social safety net to this day.

It also proved a political boon for its creators, winning Democrats votes and elections for two generations. Health care reform, however attenuated and compromised, has similar potential....

Like the current health care overhaul, which aims to expand coverage, eliminate predatory insurance practices and restrain costs, Social Security appeared to its creators as the opportunity to address several issues at once. They aimed not just to relieve the suffering of the elderly — half of whom lived in bitter poverty and almost none of whom had pensions of any kind — but also to set up a system of unemployment compensation and get poor children off the streets.

In so doing, they aimed to help the needy, especially the elderly, and also to ease pressure on the job market by getting children and the elderly out of the labor force. This tactic, they said, might return the national economy to a sustainable level of employment.

“Cradle to the grave,” President Franklin D. Roosevelt told Labor Secretary Frances Perkins, the chairman of the committee he appointed to formulate and pass his program, “from the cradle to the grave,” Americans “ought to be in a social insurance system.”

Roosevelt wanted universal coverage, too. The program, he insisted, should reach beyond the employees of large industrial corporations. “Everybody ought to be on it,” FDR told Perkins, including “the farmer and his wife and family. I don’t see why not.”...

The most important political concession, and the biggest disappointment to reformers who saw Social Security as a tool to aid the impoverished, was the decision to pay for it entirely through “contributions” — a regressive payroll tax system. They gave up the idea of supplementing benefits with income tax revenues that would more aggressively redistribute income from the affluent to the struggling.

By the time the last compromise was made, Perkins expressed the disillusionment of many reformers. The thing,” she lamented, had been “chiseled down to a conservative pattern.”...

Passing the Senate bill might mean swallowing hard in the short-term, but if Americans enjoy new benefits and protection against catastrophic illness, the politics, history shows, could shift.

Even with the compromises present at its creation, FDR, Perkins remembered, considered Social Security “the cornerstone” of his legacy. President Barack Obama and the Congress might well remember that model.